I don't want to go, but I should. Help me find a dentist and help me get over my fear.

October 16, 2009 7:39 AM

I'm scared of going to the dentist. How do I find one that will understand and how do I prepare myself for going to my first appointment in years?

Hi. I'm a 20-something woman who is coming to terms with the fact that I need to go to the dentist. It's been several years. I take very good care of my teeth, but I recognize that some problems may develop and that it would be better to prevent rather than fix. The problem is that I'm really scared.

My experience with dentists is not very good. I had a terrible experience with a dentist who lost his temper with me on my first visit as a 4 year old. He yelled at me and made me cry. After that, I went to a children's dentist and they also yelled at me, routinely left me alone in the chair for up to an hour at a time and did not seem to care about my comfort or pain levels. It seems every dentist I've had at some point ridiculed or yelled at me or caused me undue pain or neglect when it could have been prevented. I do not consider myself to be a coward and have been though surgery, routine doctor visits and many other procedures without any problems at all. It is just my extreme negative interactions with dentists that have caused me to stay away all these years.

So how do I find someone who cares? What is reasonable to ask about when you call to make an appointment? I don't feel I can outright ask, "Is Dr. Dentist a patient man/woman who will not yell at or mock me?" I live in a small town and I don't think there is sedation dentistry here. I do not know many people here to ask for recommendations. Is it reasonable to want to meet the dentist beforehand? What about the hygenists? I could have the best dentist in the world, but if his or her hygentist is not also compassionate, then what to do? They seem to spend the most time with patients on routine visits.

Assuming I find the best dentist ever, I also need help in learning how to prepare mentally. I have developed a score of phobias around the dentist. I have an extreme aversion to the grinding of teeth, which usually happens if they are moist and have toothpaste or some kind of cleaning agent on them. I dislike the vaccuum used to vaccuum out fluid and often wish that I were in control or could just spit and rinse it all out myself. I don't like being left alone in the chair. Finally, I also have an extremely powerful gag reflex that is easily triggered (probably why I hate that vaccuum thing).

So how do I cope with those things? Is there anything I can do to get over them or prevent them from happening? Is any dentist going to take those concerns seriously? If I had to rank them in terms of terror, I would put gagging as 1, grinding teeth as 2, vaccuum thing as 3 and being left alone as 4. I don't think I care as much about pain.

I recognize that I have a lot of issues, but would like to avoid therapy if at all possible. I did see this question (http://ask.metafilter.com/114191/How-can-I-find-a-dentist-who-is-good-with-terrified-patients) and it helped, but I have some specific issues I need to address and wanted to know about coping. Please help if you can.

Throwaway e-mail address: [e-mail]

TIA!

posted by anonymous to health & fitness (22 comments total)

I had dental phobias, but I was able to go after talking about it to my doctor, who recommended anti-anxiety medicine (something similar to Xanax). Combined with my favorite music on my ipod, it made a world of difference; things just seemed so much less stressful and I was able to relax and get through it. Good luck. You'll be really happy once you've done the first appointment, and subsequent visits won't be so worrisome.
posted by TochterAusElysium at 7:54 AM on October 16

Find one that will give you a prescription for Valium or Ativan before you even see them. I had a serious dentist phobia that I'm still working on (even TALKING about teeth related issues would freak me out), also due to a score of childhood dentist traumas. I went to one that collected old dental tools and hung them up in his office as decoration. And he was a pediatric dentist! I had a very strong gag reflex and he didn't care - in fact, he told me that if I threw up I'd have to clean it up myself. (This turned out to be an idle threat, ha.)

My mom finally took me to her dentist, who was very old school, but who had a nice personality. Dental visits were still torture, but I managed for a while. Then I stopped going altogether. When he retired, a young dentist took over his practice. The first time I saw him I sat down in the chair and immediately started crying. He sent me home with a prescription for Ativan and a new appointment time. Now I take a couple before any dentist appointment and it's made all the difference in the world.

Do a google search for dentists in your town and check their websites. They should say something on there about accommodating phobic patients. Then give them a call, explain your situation, and ask if they're willing to give you a prescription for Valium. You are absolutely allowed to ask if the dentist is compassionate. Tell them you've been mocked and humiliated by dentists before. If the receptionist is understanding then you've got a good chance that the dentist is as well. And I don't think a kind dentist is going to hire a jerk for an assistant.

Good luck!
posted by elsietheeel at 7:56 AM on October 16

Yes, dentists will take your concerns seriously.

The other thread really had it - nitrous oxide and xanax pre-appointment are where it's at. The first time I went to the dentist in several years, I actually broke down crying in the chair when I started gagging all over the x-ray films (I hate that part). At that point the hygienist took me aside and offered gas for the scaling and the rest of the appointment. I went to my shrink and she recommended xanax pre-appointment. After a few visits using this protocol, I found I could cope.

The thing about the hygienists - at the practice I go to, I get rotated around through a pool of hygienists, I think I've seen four or five. So I don't know how much good it will do meeting the hygienist in advance.

It is certainly worth visiting the practice in advance, however, and asking questions. Ask if they will scale your teeth using manual tools and avoid using the ultrasonic tool for scaling. This means less water in your mouth and less vacuum. The practice I work with will let me hold the vacuum. Certainly talk to the staff about not being left alone in the chair, realistically you will have to be left alone sometimes (for example while they work on your x-rays), but I think xanax and gas will go a long way here. If they are willing to talk to you about these things, then you'll probably be ok in the chair.

Good luck.
posted by crazycanuck at 8:02 AM on October 16

Find a dentist who specializes in sedation dentistry. Not only will it mean that they'll give you drugs to help you cope, it will also mean that they're specifically looking to help people who suffer from fear and anxiety about dental care, so they're more likely to be patient and compassionate.

It's perfectly reasonable to ask to meet ahead of time the practitioners (both dentist and hygienists) who will be working on you. If they refuse to let you, they're not the dental practice for you. And if you meet them and feel uncomfortable, thank them for their time and leave.
posted by decathecting at 8:06 AM on October 16

Please recommend a doctor is a somewhat common question on AskMe. I'd recommend asking for recommendations for a well-regarded dentist here. Lots of Mefites seem to be in your boat of "AAH! DENTIST! RUN!". And, having a dentist you can trust, who cares and is non-scary, is key.

We just need to know where you are.
posted by Citrus at 8:08 AM on October 16

I very recently was in your shoes, and wrote about my experiences here.
posted by TheNewWazoo at 8:09 AM on October 16

You probably already know this, but just to reinforce: the dentists you had as a child were bad, bad dentists. Most dentists are not like that.
posted by ook at 8:11 AM on October 16

Oh, I'll add that I recently went in and had that cavity filled. A valium the night before, a valium that morning, and nitrous in the chair and it was bearable. They stuck me with a needle a couple of times and I didn't faint (or even feel like I came close). Now I know that, with a little preparation and the temerity to say "DON'T DO THAT", I'm not dreading my cleaning in February.
posted by TheNewWazoo at 8:11 AM on October 16

I know you don't know many people in town, but start by getting recommendations from the people you do know (and maybe enlist their help in getting recommendations from their social networks). You don't need to bare your soul to them if you don't want to, you can simply say you're sick of high-stress, scolding dentists and want someone gentle, patient, and kind. Then, call each recommended dentist's office and explain that you're anxious about having an appointment with a new dentist and would like to meet with him/her beforehand. Ask if you can book a short time with the dentist to discuss your needs (you may have better luck asking for a consultation). It's entirely reasonable, and if a dentist or his office balks at the request, move on to the next name on your list.

When you meet with the dentist, explain what your needs and concerns are. You can ask the dentist how much time per visit you'd spend with him/her vs. with the hygienist. My husband's last dentist did all the teeth cleaning herself, my last dentist left it to his hygienists, so while the majority seem to be like mine they aren't all the same. It would also be reasonable, once the dentist understands your situation, to ask to meet the hygienist so that s/he can be informed of your needs. No dental hygienist wants to risk making a patient sick or causing a panic attack, so a brief conversation about your situation would be helpful to your hygienist as well as to you.

As for the anxiety, it is not uncommon for a small dose of anti-anxiety medication to be prescribed in this type of situation. Inquire with the dentist to see if something can be arranged prior to your appointment.
posted by Meg_Murry at 8:13 AM on October 16

My first reaction, before I'd even finished reading the question, was that the basic premise you're working from, i.e. 'I won't go to any dentist until I'm certain nothing uncomfortable will happen,' is a trap. You will never be that comfortable before you start going, and if that's a deal-breaker then you're not going to go; your teeth will get worse and eventually you will either drop your only-if-comfortable rule or you're life will be taken over by oral pain. Don't wait until you're up against that wall. Go now, despite your fear.

Having read the rest of your question, though, I'm sympathetic with how hard it is. Me early dental experiences sucked too. I didn't get yelled at, but my first dentist was an old-timer with no patience for kids, and was pretty rough. I also went through several years in my early 20s without seeing dentists, for lack of insurance, and getting back into the habit was scary. Not to minimize what you're up against - your fears have clearly gotten pretty big.

On the plus side, my experiences with dentists as an adult have been dramatically different. They talk to me like a fellow adult. I get to ask questions, and they answer, in as much detail as I generally want. I get to say 'no, that still hurts,' and they stop. I'm also a lot better at managing my own anxiety levels by distracting myself, pacing my breathing, etc. It's worth noting that I've seen, exclusively, individual dentists at private neighborhood practices - not some chain place at the mall.

In your shoes, I'd ask everyone you know how they feel about their dentists. You may learn that someone nearby is especially good. When you decide to visit a particular dentist, explain to the receptionist, and again to the hygenist, that you're freaked out and may require a bit of patience and reassurance. I assure you that you are not the first such case they've dealt with. Schedule an appointment for a time of day when they might be less busy and thus more accomodating. I usually get the first appointment of the day, which means they're never running behind and everyone seems well-rested and cheery.

But it'll still come back around to the fact that you're going to be anxious, and you'll have to push through that anxiety and do your best to manage yourself. Waiting until you're excited to go to the dentist is not going to work.
posted by jon1270 at 8:15 AM on October 16

Sorry to spam the thread, but I just wanted to add that some people interpret "sedation dentistry" to mean "anaesthetic", but that's not necessarily the case. Most dentists have nitrous, and all of them can prescribe a sedative.

The most important thing to take away from this is that you have all the power. There is nearly no scenario when you cannot say "stop" and leave. If you go in for a consult (and make it clear that you want to sit in a normal chair and talk and have nothing else done), and the dentist isn't 100% on-board with your concerns, wish them a nice day and be on your way. You don't even have to explain yourself beyond, "I'm uncomfortable and will be leaving now."
posted by TheNewWazoo at 8:16 AM on October 16

You can ask anything you want, ask to meet the dentist (expect this to be a very, very short meeting), ask to meet the hygienist, ask for whatever would make you more comfortable. If the receptionist mocks you for this, you cross that dentist off your list. It's likely that you will be paying these people a lot of money, don't feel like it's a terrible imposition to ask what the dentist is like.

Don't ask if the dentist w "will not yell at or mock me?" though -- whoever you get on the phone is hardly going to say "Yes, MY BOSS yells at and mocks people all the time" -- you will have to be more subtle in your questions.

You could get a cleaning done locally (which will not involve grinding, but might involve polishing, which sounds a lot like grinding), and get fillings and more major work done somewhere else where you can get sedated. If you really want to make sure you are not left alone, see if you can bring someone with you to the appointment. If you really can't stand the polishing that would be done during a routine cleaning, see if you can get the cleaning done without the polishing, it's still better for your teeth than not going at all.

Personally, I hate the idea of being "put under", and prefer to get major work done at a dentist that offers nitrous oxide, but fewer dentists are offering it and things seem to be moving toward sedation. If your local dentists offer this as an option you might see if it works well for you. Be aware that you can ask for them to decrease the amount you are getting if you wish.

I've heard of people finding bringing a hypnotherapist with them to the dentist to be very helpful, but have no experience with that myself.
posted by yohko at 8:20 AM on October 16

Sorry, I missed the part of your question where you mentioned sedation dentistry. But I agree with TheNewWazoo. A lot of dentists are willing and able to work with patients who need medication, and you can call them and ask. If they balk, they're not the right practice for you.

Also, you may want to consider looking outside of your own town for someone who specializes in this. Given how nervous you are, it may be worth it to travel a bit (provided you can find someone to drive you if you're going to be taking drugs) for the perfect provider.
posted by decathecting at 9:08 AM on October 16

you say you don't know a lot of people in your area to ask for recommendations. I just wanted to throw out my own experience in not being able to find a good dentist where i live. i'm not afraid of dentists per se in the same way that you are and I've never really needed anything besides some small fillings and wisdom teeth extracted, but I do have some strict standards of what I require in any medical practitioner. My childhood dental practice was exactly the right kind of place for me, and when I kept leaving dental cleanings in my new town with the sense that they just weren't as good as when I was a kid, I started making appointments with my old place, timed for Friday afternoons for example, so that I could combine the trip wtih a visit to my parents. When I needed to come back, I never could make an appointment much more than a month in advance anyway, so I just planned another weekend home.

A little extreme I think, but it has been totally worth it for me. If you can get a recommendation from a good friends in another town, maybe you could do something similar.

And I also agree with all others that your concerns should be taken seriously -- I hope you find care soon!
posted by Tandem Affinity at 9:23 AM on October 16

I have been treated the best at dental colleges. By far.

In general you get the same level of care, often at a cheaper price, but I have been treated with FAR MORE respect. It's counter-intuitive, I guess, but dental colleges are the most inviting dental atmospheres. Maybe because they see some grizzly cases or because the dentists are more humble because they are learning. I don't know, but by choice I now go to dental colleges because they are so much nicer and way less judgmental.
posted by milarepa at 9:34 AM on October 16

Dental phobia is fairly common and you can request a prescription for a relaxant like Xanax or whatever ahead of time. One of my friends has a dental phobia and has both a 'get to sleep' one for when they get insomnia from the anxiety of the upcoming visit and a 'relax for a couple hours' one to take an hour before. In their experience, the best thing was to find a gentle hygienist and always request the same one.

Dentist offices also generally have music available or will let you use your own, which is very useful for distraction. You can request them up front.

No need to be embarrassed - the instant you say 'bad previous experience', they are generally bound and determined that to give you the Best Visit Ever as a point of professional pride, I guess.
posted by bookdragoness at 10:35 AM on October 16

One way to get recommendations for dentists in your area might be to call up a few local periodontist and orthodontist offices and ask who they think are the best dentists in town. As specialists, they get to see the handiwork of many different general dentists, so if the same name comes up more than once, that may be worth pursuing.
posted by Nothlit at 11:18 AM on October 16

You say you're in a small town, but you don't say where :) If you're able/willing to drive to Fairfield, CT, I have a guy for you, mefi mail me. My sister was in your shoes and terrified to go up until about 6 months ago when she forced herself. She still talking about how nice and understanding they were and how they didn't force her to do anything she wasn't comfortable with, they let her take a break in the middle, etc. I'm gonna go see this guy when I can scrounge up the cash (it's been a while for me too.)
posted by AlisonM at 12:51 PM on October 16

(re: me getting cash to go to the dentist: I should say he takes insurance! I just don't have insurnace. Boo.)
posted by AlisonM at 12:52 PM on October 16

If it helps any, most dentists see patients on a daily basis who have gone years without visiting. It's really common, thanks to widespread dental phobias and lack of dental insurance. It's pretty rare that a dentist will make a fuss.
posted by Astro Zombie at 1:44 PM on October 16

I have (had) a gag reflex from hell. I actually got FIRED from my previous dentist when I needed a root canal because he had enough of dealing with me (and he was the nicest dentist I had encountered so far).

I looked around for dentist recommendations online. This may not work for you because my town is filled with geeks and has a very extensive wiki with recommendations, but I definitely was able to make a list of who looked good. Then I started calling and flat-out asked the receptionist if they were able to deal with severe gag reflex issues.

"We'll give it a shot," she said. And the dentist I had now managed to freaking REHAB my gag reflex. Nice as pie. I went there today and didn't gag, cry, or anything. He gave me a prescription for Halcion to take before dental appointments. He also had a custom solution made up with the chemical diclonine (I am probably misspelling this) that he gave to patients to numb their mouths up before unpleasant procedures. After much begging on my part, he got me a prescription to get a month's supply. It was crazy expensive, but after about 3 weeks I stopped gagging and haven't barfed on my brush since. I definitely think having a geek dentist is the way to go. If you live in NorCal, PM me and I'll pass on the name. But assuming you're not, I've at least given you a few things to ask someone about with regards to solutions.

Assuming that you live in a small town and can't find any recommendations online and somehow can't ask anyone you know in real life who they'd recommend, I'd just say to ask the receptionist how well the dentist deals with gag reflexes/your other problems. If they give you attitude about it, then don't go to them.
posted by jenfullmoon at 3:05 PM on October 16

Nitrous, woo!

Also practice, in your mind, telling the dentist and his hygienist and the receptionist:

NO
STOP
I DON'T LIKE THAT
NO
DON'T DO THAT
I NEED MORE NITROUS
I NEED MORE PAIN MEDICATION
STOP, I NEED TO COME BACK ANOTHER TIME
I'M GOING TO PUKE
NO
posted by kathrineg at 3:43 PM on October 16